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调查肥胖症手术前后患者铜和锌异常的发生率——澳大利亚的经验。

Investigating the Prevalence of Copper and Zinc Abnormalities in Patients Pre and Post bariatric Surgery-an Australian Experience.

机构信息

School of Medical, Indigenous and Health Sciences, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.

Shore Surgical, 156-158 Pacific Highway, Greenwhich, Sydney, NSW, 2065, Australia.

出版信息

Obes Surg. 2023 Nov;33(11):3437-3446. doi: 10.1007/s11695-023-06822-w. Epub 2023 Sep 29.

Abstract

INTRODUCTION

Bariatric surgery predisposes patients to nutritional deficiencies. There are limited studies on zinc and copper abnormalities in this cohort.

PURPOSE

The aim of this study was to identify the prevalence of these abnormalities in a cohort of Australian bariatric patients. Inflammatory markers, adherence to multivitamin supplementation (MVS) and the presence of gastrointestinal (GI) symptoms were also investigated.

MATERIAL AND METHODS

Data was collected on all patients who attended a single clinic in Sydney, Australia, from August 2020 to August 2021.

RESULTS

The study cohort consisted of 231 patients (76.2% female; mean pre-operative body mass index of 43.4 ± 7.1 kg/m), most of whom underwent sleeve gastrectomy (78.8%). Data were collected preoperatively and then at ≤ 6 months, 1 and > 2 years postoperatively. Prior to surgery, low levels of zinc (2.1%) and copper (0.7%) were rare, but elevated copper levels were common (16.7%) and potentially related to an elevated C-reactive protein (CRP) (47.7%). Following surgery at > 2 years, the mean total weight loss (TWL) was 33.5 ± 12.4. CRP levels improved over time. Post operatively, low zinc (2.7-3.6%) and copper (1.5%) levels were rare. Patients with low levels in zinc and copper were a higher-risk group and generally exhibited GI symptoms, despite taking MVS.

CONCLUSION

In the initial post-operative stages and with good adherence to MVS containing copper and zinc, abnormalities may not be a concern. Patients with GI symptoms appear to be at higher risk of abnormalities; increasing awareness, thorough screening, and more comprehensive supplementation are recommended.

摘要

简介

减重手术使患者容易出现营养缺乏。关于该队列人群中锌和铜异常的研究有限。

目的

本研究旨在确定澳大利亚肥胖患者队列中这些异常的患病率。还研究了炎症标志物、对多种维生素补充剂(MVS)的依从性以及胃肠道(GI)症状的存在。

材料和方法

数据收集自 2020 年 8 月至 2021 年 8 月期间在澳大利亚悉尼的一家诊所就诊的所有患者。

结果

研究队列由 231 名患者组成(76.2%为女性;平均术前体重指数为 43.4±7.1kg/m),其中大多数接受了袖状胃切除术(78.8%)。数据在术前收集,然后在术后≤6 个月、1 年和>2 年收集。手术前,锌(2.1%)和铜(0.7%)水平低的情况很少见,但铜水平升高很常见(16.7%),可能与 C 反应蛋白(CRP)升高(47.7%)有关。术后>2 年时,平均总体重减轻(TWL)为 33.5±12.4。CRP 水平随时间改善。术后锌(2.7-3.6%)和铜(1.5%)水平低的情况很少见。锌和铜水平低的患者是高危人群,尽管服用了 MVS,但通常表现出 GI 症状。

结论

在术后早期阶段,并且 MVS 中含有铜和锌,异常可能不是问题。有胃肠道症状的患者似乎异常风险更高;建议提高认识、彻底筛查和更全面的补充。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c7a/10602995/e837d1308879/11695_2023_6822_Fig1_HTML.jpg

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